About the Pacific Telemedicine Network

This Project seeks to achieve five goals:

  • Install Network connected diagnostic tools and video systems in 6 rural clinics/healthcare centers in the Commonwealth of the Northern Mariana Islands using a Delay Tolerant Network (DTN) to mitigate loss of connectivity.
  • Connect rural physicians to resources in Ventura, California using new telemedicine equipment and Direct Health Information Exchange for document delivery.
  • Establish Provider / Healthcare Directory Services
  • Train participating nurses, physician’s assistants and doctors in multiple segments of telemedicine skills.
  • Empower patients to understand how telemedicine can improve their health and to use Direct Exchange to connect with their physicians and participate in their care.
  • Implement an expansion of Direct Health Information Exchange access for rural patients.

Participating Sites:

Hub: Ventura County Medical Center – Ventura, California:

Ventura County Health will serve as the project hub.

Contact: Chris Landon, MD – chris.landon@ventura.org


HISP: RAIN Live Oak HE and Telemedicine Network – Santa Barbara, California:

The telemedicine Network will link the Hub site and each rural CNMI clinic to the hub’s services, education materials and telediagnostic resources.  RAIN is also establishing a FHIR standards Healthcare Directory / Provider Directory Service.

Contact: Timothy Tyndall – timothy@rain.org


CNMI End user sites: six facilities located on the three southernmost islands of Saipan, Tinian and Rota.

Contact: Esther Muna – esther.muna@dph.gov.mp

CNMI Sites receiving Telemedicine equipment:

  • Commonwealth Health Center Health Clinics, Garapan
  • Kagman Community Health Center, Kagman Community (east)
  • San Roque Health Center – San Roque and northern villages
  • Rota Health Center – island of Rota
  • Tinian Health Center – island of Tinian
  • San Antonio Health clinic – San Antonio and southern villages


Each clinic will be equipped with a dedicated telemedicine equipment cart capable of facilitating a full telemedicine encounter and taking a spectrum of readings and diagnostic information. Each cart will act as an independent server, allowing remote physicians to securely sign-on from any location to view telediagnostic readings and interact via video conferencing.

Rural connections will be reinforced with Disruption Tolerant Networking (DTN) transport tools to overcome unreliable connectivity to the mainland and to minimize data loss during outages.

This project is planned to span two years:

  • Year 1 (twelve months) : installation of telediagnostic equipment, site visits and initial clinical encounters, coordinating efforts between California and the Northern Mariana Islands to establish a lasting telemedicine network in the region to serve rural residents.
  • Year 2 (twelve months) : nurse / provider / patient training in telemedicine applications, integration of all telemedicine encounters into EHR systems and integration of HIE Networks in CNMI and California.


The telemedicine equipment has three purposes:

  • First, to establish a low cost and sustainable rural telemedicine network that brings improved health care to rural areas with limited resources.
  • Second, to provide the telemedicine diagnostic equipment that health care providers in these rural areas need. The tools included with the Clinical Assist Cart create a mobile clinic and will be complemented by training that enables regional healthcare providers to make full use of telediagnostic equipment.
  • Third, to provide teaching tools to prepare nurses and physician assistants to act as skilled telemedicine presenters.


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